Circular stapler with selectable motorized and manual control

ABSTRACT

An apparatus is operable to clamp, cut, and staple tissue. The apparatus includes a stapling head assembly, a shaft assembly coupled to the stapling head assembly, and an actuator handle assembly coupled to the shaft assembly. The stapling head assembly is operable to clamp tissue, cut tissue, and staple tissue in response to rotation imparted by a single rotary drive shaft extending through the shaft assembly. The actuator handle assembly includes a motor positioned within a motor housing, a rotation knob, and a selection assembly. The rotation knob is coupled to a proximal end of the motor housing. The rotation knob is configured to translate between a proximal position and a distal position. The selection assembly is operable to select between motorized operation of the apparatus or manual operation of the apparatus, based on the longitudinal position of the rotation knob.

BACKGROUND

In some settings, a surgeon may want to position a surgical instrumentthrough an orifice of the patient and use the instrument to adjust,position, attach, and/or otherwise interact with tissue within thepatient. For instance, in some surgical procedures, portions of thegastrointestinal tract may be cut and removed to eliminate undesirabletissue or for other reasons. Once the desired tissue is removed, theremaining portions may need to be recoupled together. One such tool foraccomplishing these anastomotic procedures is a circular stapler that isinserted through a patient's orifice.

Examples of circular surgical staplers are described in U.S. Pat. No.5,205,459, entitled “Surgical Anastomosis Stapling Instrument,” issuedApr. 27, 1993; U.S. Pat. No. 5,271,544, entitled “Surgical AnastomosisStapling Instrument,” issued Dec. 21, 1993; U.S. Pat. No. 5,275,322,entitled “Surgical Anastomosis Stapling Instrument,” issued Jan. 4,1994; U.S. Pat. No. 5,285,945, entitled “Surgical Anastomosis StaplingInstrument,” issued Feb. 15, 1994; U.S. Pat. No. 5,292,053, entitled“Surgical Anastomosis Stapling Instrument,” issued Mar. 8, 1994; U.S.Pat. No. 5,333,773, entitled “Surgical Anastomosis Stapling Instrument,”issued Aug. 2, 1994; U.S. Pat. No. 5,350,104, entitled “SurgicalAnastomosis Stapling Instrument,” issued Sep. 27, 1994; and U.S. Pat.No. 5,533,661, entitled “Surgical Anastomosis Stapling Instrument,”issued Jul. 9, 1996. The disclosure of each of the above-cited U.S.Patents is incorporated by reference herein. Some such staplers areoperable to clamp down on layers of tissue, cut through the clampedlayers of tissue, and drive staples through the layers of tissue tosubstantially seal the severed layers of tissue together near thesevered ends of the tissue layers, thereby joining two severed ends ofan anatomical lumen.

Merely additional other exemplary surgical staplers are disclosed inU.S. Pat. No. 4,805,823, entitled “Pocket Configuration for InternalOrgan Staplers,” issued Feb. 21, 1989; U.S. Pat. No. 5,415,334, entitled“Surgical Stapler and Staple Cartridge,” issued May 16, 1995; U.S. Pat.No. 5,465,895, entitled “Surgical Stapler Instrument,” issued Nov. 14,1995; U.S. Pat. No. 5,597,107, entitled “Surgical Stapler Instrument,”issued Jan. 28, 1997; U.S. Pat. No. 5,632,432, entitled “SurgicalInstrument,” issued May 27, 1997; U.S. Pat. No. 5,673,840, entitled“Surgical Instrument,” issued Oct. 7, 1997; U.S. Pat. No. 5,704,534,entitled “Articulation Assembly for Surgical Instruments,” issued Jan.6, 1998; U.S. Pat. No. 5,814,055, entitled “Surgical ClampingMechanism,” issued Sep. 29, 1998; U.S. Pat. No. 6,978,921, entitled“Surgical Stapling Instrument Incorporating an E-Beam Firing Mechanism,”issued Dec. 27, 2005; U.S. Pat. No. 7,000,818, entitled “SurgicalStapling Instrument Having Separate Distinct Closing and FiringSystems,” issued Feb. 21, 2006; U.S. Pat. No. 7,143,923, entitled“Surgical Stapling Instrument Having a Firing Lockout for an UnclosedAnvil,” issued Dec. 5, 2006; U.S. Pat. No. 7,303,108, entitled “SurgicalStapling Instrument Incorporating a Multi-Stroke Firing Mechanism with aFlexible Rack,” issued Dec. 4, 2007; U.S. Pat. No. 7,367,485, entitled“Surgical Stapling Instrument Incorporating a Multistroke FiringMechanism Having a Rotary Transmission,” issued May 6, 2008; U.S. Pat.No. 7,380,695, entitled “Surgical Stapling Instrument Having a SingleLockout Mechanism for Prevention of Firing,” issued Jun. 3, 2008; U.S.Pat. No. 7,380,696, entitled “Articulating Surgical Stapling InstrumentIncorporating a Two-Piece E-Beam Firing Mechanism,” issued Jun. 3, 2008;U.S. Pat. No. 7,404,508, entitled “Surgical Stapling and CuttingDevice,” issued Jul. 29, 2008; U.S. Pat. No. 7,434,715, entitled“Surgical Stapling Instrument Having Multistroke Firing with OpeningLockout,” issued Oct. 14, 2008; and U.S. Pat. No. 7,721,930, entitled“Disposable Cartridge with Adhesive for Use with a Stapling Device,”issued May 25, 2010. The disclosure of each of the above-cited U.S.Patents is incorporated by reference herein. While the surgical staplersreferred to above are described as being used in endoscopic procedures,it should be understood that such surgical staplers may also be used inopen procedures and/or other non-endoscopic procedures.

While various kinds of surgical stapling instruments and associatedcomponents have been made and used, it is believed that no one prior tothe inventor(s) has made or used the invention described in the appendedclaims.

BRIEF DESCRIPTION OF THE DRAWINGS

While the specification concludes with claims which particularly pointout and distinctly claim this technology, it is believed this technologywill be better understood from the following description of certainexamples taken in conjunction with the accompanying drawings, in whichlike reference numerals identify the same elements and in which:

FIG. 1 depicts a side elevation view of an exemplary circular staplingsurgical instrument;

FIG. 2A depicts an enlarged longitudinal cross-section view of anexemplary stapling head assembly of the instrument of FIG. 1 showing anexemplary anvil in an open position;

FIG. 2B depicts an enlarged longitudinal cross-sectional view of thestapling head assembly of FIG. 2A showing the anvil in a closedposition;

FIG. 2C depicts an enlarged longitudinal cross-sectional view of thestapling head assembly of FIG. 2A showing an exemplary staple driver andblade in a fired position;

FIG. 3 depicts an enlarged partial cross-sectional view of an exemplarystaple formed against the anvil;

FIG. 4A depicts an enlarged side elevation view of an exemplary actuatorhandle assembly of the surgical instrument of FIG. 1 with a portion ofthe body removed, showing a trigger in an unfired position and a lockoutfeature in a locked position;

FIG. 4B depicts an enlarged side elevation view of the actuator handleassembly of FIG. 4A, showing the trigger in a fired position and thelockout feature in an unlocked position;

FIG. 5 depicts an enlarged partial perspective view of an exemplaryindicator assembly of the surgical instrument of FIG. 1 showing anindicator window and indicator lever;

FIG. 6 depicts an diagrammatic view of the indicator window of FIG. 5showing an exemplary indicator bar and exemplary corresponding staplerepresentations;

FIG. 7 depicts a perspective view of another exemplary circular staplingsurgical instrument;

FIG. 8 depicts an exploded view of the handle and shaft assemblies ofthe instrument of FIG. 7;

FIG. 9 depicts a cross sectional view of the handle assembly of theinstrument of FIG. 7;

FIG. 10 depicts an enlarged, partial cross sectional view of the motorand battery assemblies of FIG. 7;

FIG. 11A depicts a side elevational view of an operational modeselection assembly of the instrument of FIG. 7, with a first geardisengaged from a second gear;

FIG. 11B depicts a side elevational view of the operational modeselection assembly of FIG. 11A, with the first gear engaged with thesecond gear;

FIG. 12 depicts a front elevational view of the first gear of theoperational mode selection assembly of FIG. 11A;

FIG. 13 depicts a perspective view of the second gear of the operationalmode selection assembly of FIG. 11A;

FIG. 14 depicts an enlarged, partial perspective view of the handleassembly of the instrument of FIG. 7;

FIG. 15A depicts a cross sectional view of the instrument of FIG. 7,with a motorized operational mode selected, showing an anvil beingcoupled to a trocar;

FIG. 15B depicts a cross sectional view of the instrument of FIG. 7,with a motorized operational mode selected, in a tissue clampingposition;

FIG. 15C depicts a cross sectional view of the instrument of FIG. 7,with a motorized operational mode selected, in a fired position;

FIG. 16 depicts a cross sectional view of the handle assembly of theinstrument of FIG. 7 showing the manual operational mode being selected;

FIG. 17A depicts a cross sectional view of the instrument of FIG. 7,with a manual operational mode selected, showing an anvil being coupledto a trocar;

FIG. 17B depicts a cross sectional view of the instrument of FIG. 7,with a manual operational mode selected, in a tissue clamping position;

FIG. 17C depicts a cross sectional view of the instrument of FIG. 7,with a manual operational mode selected, in a fired position;

FIG. 18 depicts a schematic of an exemplary control assembly for usewith the instrument of FIG. 7;

FIG. 19 depicts a partial perspective view of another exemplaryoperational mode selection assembly; and

FIG. 20 depicts a front view of the operational mode selection assemblyof FIG. 19.

The drawings are not intended to be limiting in any way, and it iscontemplated that various embodiments of the technology may be carriedout in a variety of other ways, including those not necessarily depictedin the drawings. The accompanying drawings incorporated in and forming apart of the specification illustrate several aspects of the presenttechnology, and together with the description serve to explain theprinciples of the technology; it being understood, however, that thistechnology is not limited to the precise arrangements shown.

DETAILED DESCRIPTION

The following description of certain examples of the technology shouldnot be used to limit its scope. Other examples, features, aspects,embodiments, and advantages of the technology will become apparent tothose skilled in the art from the following description, which is by wayof illustration, one of the best modes contemplated for carrying out thetechnology. As will be realized, the technology described herein iscapable of other different and obvious aspects, all without departingfrom the technology. Accordingly, the drawings and descriptions shouldbe regarded as illustrative in nature and not restrictive.

I. Overview of Exemplary Circular Stapling Surgical Instrument

FIGS. 1-6 depict an exemplary circular surgical stapling instrument (10)having a stapling head assembly (20), a shaft assembly (60), and anactuator handle assembly (70), each of which will be described in moredetail below. Shaft assembly (60) extends distally from actuator handleassembly (70) and stapling head assembly (20) is coupled to a distal endof shaft assembly (60). In brief, actuator handle assembly (70) isoperable to actuate a staple driver (24) of stapling head assembly (20)to drive a plurality of staples (66) out of stapling head assembly (20).Staples (66) are bent to form completed staples by an anvil (40) that isattached at the distal end of instrument (10). Accordingly, tissue (2),shown in FIGS. 2A-2C, may be stapled utilizing instrument (10).

In the present example, instrument (10) comprises a closure system and afiring system. The closure system comprises a trocar (38), a trocaractuator (39), and a rotating knob (98). An anvil (40) may be coupled toa distal end of trocar (38). Rotating knob (98) is operable tolongitudinally translate trocar (38) relative to stapling head assembly(20), thereby translating anvil (40) when anvil (40) is coupled totrocar (38), to clamp tissue between anvil (40) and stapling headassembly (20). The firing system comprises a trigger (74), a triggeractuation assembly (84), a driver actuator (64), and a staple driver(24). Staple driver (24) includes a knife (36) configured to severtissue when staple driver (24) is actuated longitudinally. In addition,staples (66) are positioned distal to a plurality of staple drivingmembers (30) of staple driver (24) such that staple driver (24) alsodrives staples (66) distally when staple driver (24) is actuatedlongitudinally. Thus, when trigger (74) is actuated and triggeractuation assembly (84) actuates staple driver (24) via driver actuator(64), knife (36) and members (30) substantially simultaneously severtissue (2) and drive staples (66) distally relative to stapling headassembly (20) into tissue. The components and functionalities of theclosure system and firing system will now be described in greaterdetail.

A. Exemplary Anvil

As shown in FIGS. 1-2C, anvil (40) is selectively coupleable toinstrument (10) to provide a surface against which staples (66) may bebent to staple material contained between stapling head assembly (20)and anvil (40). Anvil (40) of the present example is selectivelycoupleable to a trocar or pointed rod (38) that extends distallyrelative to stapling head assembly (20). Referring to FIGS. 2A-2C, anvil(40) is selectively coupleable via the coupling of a proximal shaft (42)of anvil (40) to a distal tip of trocar (38). Anvil (40) comprises agenerally circular anvil head (48) and a proximal shaft (42) extendingproximally from anvil head (48). In the example shown, proximal shaft(42) comprises a tubular member (44) having resiliently biased retainingclips (46) to selectively couple anvil (40) to trocar (38), though thisis merely optional, and it should be understood that other retentionfeatures for coupling anvil (40) to trocar (38) may be used as well. Forexample, C-clips, clamps, threading, pins, adhesives, etc. may beemployed to couple anvil (40) to trocar (38). In addition, while anvil(40) is described as selectively coupleable to trocar (38), in someversions proximal shaft (42) may include a one-way coupling feature suchthat anvil (40) cannot be removed from trocar (38) once anvil (40) isattached. Merely exemplary one-way features include barbs, one waysnaps, collets, collars, tabs, bands, etc. Of course still otherconfigurations for coupling anvil (40) to trocar (38) will be apparentto one of ordinary skill in the art in view of the teachings herein. Forinstance, trocar (38) may instead be a hollow shaft and proximal shaft(42) may comprise a sharpened rod that is insertable into the hollowshaft.

Anvil head (48) of the present example comprises a plurality of stapleforming pockets (52) formed in a proximal face (50) of anvil head (48).Accordingly, when anvil (40) is in the closed position and staples (66)are driven out of stapling head assembly (20) into staple formingpockets (52), as shown in FIG. 2C, legs (68) of staples (66) are bent toform completed staples.

With anvil (40) as a separate component, it should be understood thatanvil (40) may be inserted and secured to a portion of tissue (2) priorto being coupled to stapling head assembly (20). By way of example only,anvil (40) may be inserted into and secured to a first tubular portionof tissue (2) while instrument (10) is inserted into and secured to asecond tubular portion of tissue (2). For instance, the first tubularportion of tissue (2) may be sutured to or about a portion of anvil(40), and the second tubular portion of tissue (2) may be sutured to orabout trocar (38).

As shown in FIG. 2A, anvil (40) is then coupled to trocar (38). Trocar(38) of the present example is shown in a distal most actuated position.Such an extended position for trocar (38) may provide a larger area towhich tissue (2) may be coupled prior to attachment of anvil (40). Inaddition, the extended position of trocar (38) may also provide foreasier attachment of anvil (40) to trocar (38). Trocar (38) furtherincludes a tapered distal tip. Such a tip may be capable of piercingthrough tissue and/or aiding the insertion of anvil (40) on to trocar(38), though the tapered distal tip is merely optional. For instance, inother versions trocar (38) may have a blunt tip. In addition, or in thealternative, trocar (38) may include a magnetic portion (not shown)which may attract anvil (40) towards trocar (38). Of course stillfurther configurations and arrangements for anvil (40) and trocar (38)will be apparent to one of ordinary skill in the art in view of theteachings herein.

When anvil (40) is coupled to trocar (38), the distance between aproximal face of the anvil (40) and a distal face of stapling headassembly (20) defines a gap distance d. Trocar (38) of the presentexample is translatable longitudinally relative to stapling headassembly (20) via an adjusting knob (98) located at a proximal end ofactuator handle assembly (70), as will be described in greater detailbelow. Accordingly, when anvil (40) is coupled to trocar (38), rotationof adjusting knob (98) enlarges or reduces gap distance d by actuatinganvil (40) relative to stapling head assembly (20). For instance, asshown sequentially in FIGS. 2A-2B, anvil (40) is shown actuatingproximally relative to actuator handle assembly (70) from an initial,open position to a closed position, thereby reducing the gap distance dand the distance between the two portions of tissue (2) to be joined.Once the gap distance d is brought within a predetermined range,stapling head assembly (20) may be fired, as shown in FIG. 2C, to stapleand sever tissue (2) between anvil (40) and stapling head assembly (20).Stapling head assembly (20) is operable to staple and sever tissue (2)by a user pivoting a trigger (74) of actuator handle assembly (70), aswill be described in greater detail below.

As noted above, gap distance d corresponds to the distance between anvil(40) and stapling head assembly (20). When instrument (10) is insertedinto a patient, this gap distance d may not be easily viewable.Accordingly, a moveable indicator bar (110), shown in FIGS. 5-6, isprovided to be visible through an indicator window (120) positionedopposite to trigger (74). Indicator bar (110) is operable to move inresponse to rotation of adjusting knob (98) such that the position ofindicator bar (110) is representative of the gap distance d. As shown inFIG. 6, indicator window (120) further comprises a scale (130) whichindicates that the anvil gap is within a desired operating range (e.g.,a green colored region or “green zone”) and a corresponding staplecompression representation at each end of scale (130). By way of exampleonly, as shown in FIG. 6, a first staple image (132) depicts a largestaple height while a second staple image (134) depicts a small stapleheight. Accordingly, a user can view the position of the coupled anvil(40) relative to the stapling head assembly (20) via indicator bar (110)and scale (130). The user may then adjust the positioning of anvil (40)via adjusting knob (98) accordingly.

Referring back to FIGS. 2A-2C, a user sutures a portion of tissue (2)about tubular member (44) such that anvil head (48) is located within aportion of the tissue (2) to be stapled. When tissue (2) is attached toanvil (40), retaining clips (46) and a portion of tubular member (44)protrude out from tissue (2) such that the user may couple anvil (40) totrocar (38). With tissue (2) coupled to trocar (38) and/or anotherportion of stapling head assembly (20), the user attaches anvil (40) totrocar (38) and actuates anvil (40) proximally towards stapling headassembly (20) to reduce the gap distance d. Once instrument (10) iswithin the operating range, the user then staples together the ends oftissue (2), thereby forming a substantially contiguous tubular portionof tissue (2).

Anvil (40) may be further constructed in accordance with at least someof the teachings of U.S. Pat. No. 5,205,459; U.S. Pat. No. 5,271,544;U.S. Pat. No. 5,275,322; U.S. Pat. No. 5,285,945; U.S. Pat. No.5,292,053; U.S. Pat. No. 5,333,773; U.S. Pat. No. 5,350,104; U.S. Pat.No. 5,533,661, the disclosures of which are incorporated by referenceherein; and/or in accordance with other configurations as will beapparent to one of ordinary skill in the art in view of the teachingsherein.

B. Exemplary Stapling Head Assembly

Stapling head assembly (20) of the present example is coupled to adistal end of shaft assembly (60) and comprises a tubular casing (22)housing a slidable staple driver (24) and a plurality of staples (66)contained within staple pockets (32). Staples (66) and staple pockets(32) are disposed in a circular array about tubular casing (22). In thepresent example, staples (66) and staple pockets (32) are disposed in apair of concentric annular rows of staples (66) and staple pockets (32).Staple driver (24) is operable to actuate longitudinally within tubularcasing (22) in response to rotation of trigger (74) of actuator handleassembly (70). As shown in FIGS. 2A-2C, staple driver (24) comprises aflared cylindrical member having a trocar opening (26), a central recess(28), and a plurality of members (30) disposed circumferentially aboutcentral recess (28) and extending distally relative to shaft assembly(60). Each member (30) is configured to contact and engage acorresponding staple (66) of the plurality of staples (66) within staplepockets (32). Accordingly, when staple driver (24) is actuated distallyrelative to actuator handle assembly (70), each member (30) drives acorresponding staple (66) out of its staple pocket (32) through a stapleaperture (34) formed in a distal end of tubular casing (22). Becauseeach member (30) extends from staple driver (24), the plurality ofstaples (66) are driven out of stapling head assembly (20) atsubstantially the same time. When anvil (40) is in the closed position,staples (66) are driven into staple forming pockets (52) to bend legs(68) of the staples (66), thereby stapling the material located betweenanvil (40) and stapling head assembly (20). FIG. 3 depicts one merelyexemplary staple (66) driven by a member (30) into a staple formingpocket (32) of anvil (40) to bend legs (68).

Staple driver (24) further includes a cylindrical knife (36) that iscoaxial to trocar opening (26) and inset from staple pockets (32). Inthe present example, cylindrical knife (36) is disposed within centralrecess (28) to translate distally with staple driver (24). When anvil(40) is secured to trocar (38), as described above, anvil head (48)provides a surface against which cylindrical knife (36) cuts thematerial contained between anvil (40) and stapling head assembly (20).In some versions, anvil head (48) may include a recess (not shown) forcylindrical knife (36) to aid in cutting the material (e.g., byproviding a cooperative shearing edge). In addition, or in thealternative, anvil head (48) may include one or more opposingcylindrical knives (not shown) offset from cylindrical knife (36) suchthat a scissor-type cutting action may be provided. Still otherconfigurations will be apparent to one of ordinary skill in the art inview of the teachings herein. Stapling head assembly (20) is thusoperable to both staple and cut tissue (2) substantially simultaneouslyin response to actuation by actuator handle assembly (70).

Of course stapling head assembly (20) may be further constructed inaccordance with at least some of the teachings of U.S. Pat. No.5,205,459; U.S. Pat. No. 5,271,544; U.S. Pat. No. 5,275,322; U.S. Pat.No. 5,285,945; U.S. Pat. No. 5,292,053; U.S. Pat. No. 5,333,773; U.S.Pat. No. 5,350,104; U.S. Pat. No. 5,533,661, the disclosures of whichare incorporated by reference herein; and/or in accordance with otherconfigurations as will be apparent to one of ordinary skill in the artin view of the teachings herein.

As noted previously, staple driver (24) includes a trocar opening (26).Trocar opening (26) is configured to permit trocar (38) tolongitudinally slide relative to stapling head assembly (20) and/orshaft assembly (60). As shown in FIGS. 2A-2C, trocar (38) is coupled toa trocar actuator (39) such that trocar (38) can be actuatedlongitudinally via rotation of rotating knob (98), as will be describedin greater detail below in reference to actuator handle assembly (70).In the present example, trocar actuator (39) comprises an elongated,relatively stiff shaft coupled to trocar (38), though this is merelyoptional. In some versions, actuator (39) may comprise a longitudinallystiff material while permitting lateral bending such that portions ofinstrument (10) may be selectively bent or curved during use; orinstrument (10) may include a preset bent shaft assembly (60). Onemerely exemplary material is nitinol. When anvil (40) is coupled totrocar (38), trocar (38) and anvil (40) are translatable via actuator(39) to adjust the gap distance d between anvil (40) and stapling headassembly (20). Still further configurations for actuator (39) tolongitudinally actuate trocar (38) will be apparent to one of ordinaryskill in the art in view of the teachings herein.

C. Exemplary Shaft Assembly

Stapling head assembly (20) and trocar (38) are positioned at a distalend of shaft assembly (60), as shown in FIGS. 2A-2C. Shaft assembly (60)of the present example comprises an outer tubular member (62) and adriver actuator (64). Outer tubular member (62) is coupled to tubularcasing (22) of stapling head assembly (20) and to a body (72) ofactuator handle assembly (70), thereby providing a mechanical ground forthe actuating components therein. The proximal end of driver actuator(64) is coupled to a trigger actuation assembly (84) of actuator handleassembly (70), described below. The distal end of driver actuator (64)is coupled to staple driver (24) such that the rotation of trigger (74)longitudinally actuates staple driver (24). As shown in FIGS. 2A-2C,driver actuator (64) comprises a tubular member having an openlongitudinal axis such that actuator (39) coupled to trocar (38) mayactuate longitudinally within and relative to driver actuator (64). Ofcourse it should be understood that other components may be disposedwithin driver actuator (64) as will be apparent to one of ordinary skillin the art in view of the teachings herein.

Shaft assembly (60) may be further constructed in accordance with atleast some of the teachings of U.S. Pat. No. 5,205,459; U.S. Pat. No.5,271,544; U.S. Pat. No. 5,275,322; U.S. Pat. No. 5,285,945; U.S. Pat.No. 5,292,053; U.S. Pat. No. 5,333,773; U.S. Pat. No. 5,350,104; U.S.Pat. No. 5,533,661, the disclosures of which are incorporated byreference herein; and/or in accordance with other configurations as willbe apparent to one of ordinary skill in the art in view of the teachingsherein.

D. Exemplary Actuator Handle Assembly

Referring now to FIGS. 4A-5, actuator handle assembly (70) comprises abody (72), a trigger (74), a lockout feature (82), a trigger actuationassembly (84), and a trocar actuation assembly (90). Trigger (74) of thepresent example is pivotably mounted to body (72) and is coupled totrigger actuation assembly (84) such that rotation of trigger (74) froman unfired position (shown in FIG. 4A) to a fired position (shown inFIG. 4B) actuates driver actuator (64) described above. A spring (78) iscoupled to body (72) and trigger (74) to bias trigger (74) towards theunfired position. Lockout feature (82) is a pivotable member that iscoupled to body (72). In a first, locked position, lockout feature (82)is pivoted upwards and away from body (72) such that lockout feature(82) engages trigger (74) and mechanically resists actuation of trigger(74) by a user. In a second, unlocked position, such as that shown inFIGS. 1 and 4B, lockout feature (82) is pivoted downward such thattrigger (74) may be actuated by the user. Accordingly, with lockoutfeature (82) in the second position, trigger (74) can engage a triggeractuation assembly (84) to fire instrument (10).

As shown in FIGS. 4A-4B, trigger actuation assembly (84) of the presentexample comprises a slidable trigger carriage (86) engaged with aproximal end of driver actuator (64). Carriage (86) includes a set oftabs (88) on a proximal end of carriage (86) to retain and engage a pairof trigger arms (76) extending from trigger (74). Accordingly, whentrigger (74) is pivoted, carriage (86) is actuated longitudinally andtransfers the longitudinal motion to driver actuator (64). In theexample shown, carriage (86) is fixedly coupled to the proximal end ofdriver actuator (64), though this is merely optional. Indeed, in onemerely exemplary alternative, carriage (86) may simply abut driveractuator (64) while a distal spring (not shown) biases driver actuator(64) proximally relative to actuator handle assembly (70).

Trigger actuation assembly (84) may be further constructed in accordancewith at least some of the teachings of U.S. Pat. No. 5,205,459; U.S.Pat. No. 5,271,544; U.S. Pat. No. 5,275,322; U.S. Pat. No. 5,285,945;U.S. Pat. No. 5,292,053; U.S. Pat. No. 5,333,773; U.S. Pat. No.5,350,104; U.S. Pat. No. 5,533,661, the disclosures of which areincorporated by reference herein; and/or in accordance with otherconfigurations as will be apparent to one of ordinary skill in the artin view of the teachings herein.

Body (72) also houses a trocar actuation assembly (90) configured toactuate trocar (38) longitudinally in response to rotation of adjustingknob (98). As best shown in FIGS. 4A-5, trocar actuation assembly (90)of the present example comprises adjusting knob (98), a grooved shank(94), and a sleeve (92). Grooved shank (94) of the present example islocated at a distal end of trocar actuator (39), though it should beunderstood that grooved shank (94) and trocar actuator (39) mayalternatively be separate components that engage to transmitlongitudinal movement. Adjusting knob (98) is rotatably supported by theproximal end of body (72) and is operable to rotate sleeve (92) that isengaged with grooved shank (94) via an internal tab (not shown). Groovedshank (94) of the present example comprises a continuous groove (96)formed in the outer surface of grooved shank (94). Accordingly, whenadjusting knob (98) is rotated, the internal tab rides within groove(96) and grooved shank (94) is longitudinally actuated relative tosleeve (92). Since grooved shank (94) is located at the distal end oftrocar actuator (39), rotating adjusting knob (98) in a first directionadvances trocar actuator (39) distally relative to actuator handleassembly (70). Accordingly, the gap distance d between anvil (40) andstapling head assembly (20) is increased. By rotating adjusting knob(98) in the opposite direction, trocar actuator (39) is actuatedproximally relative to actuator handle assembly (70) to reduce the gapdistance d between anvil (40) and stapling head assembly (20). Thus,trocar actuation assembly (90) is operable to actuate trocar (38) inresponse to rotating adjustment knob (98). Of course otherconfigurations for trocar actuation assembly (90) will be apparent toone of ordinary skill in the art in view of the teachings herein.

Groove (96) of the present example comprises a plurality of differentportions (96A, 96B, 96C) that have a varying pitch or number of groovesper axial distance. The present groove (96) is divided into a distalportion (96A), a middle portion (96B) and a proximal portion (96C). Asshown in FIG. 5, distal portion (96A) comprises a fine pitch or a highnumber of grooves over a short axial distance of grooved shank (94) suchthat a large number of rotations of adjusting knob (98) are required totraverse the short axial distance. Middle portion (96B) comprises asection with comparably coarser pitch or fewer grooves per axialdistance such that relatively few rotations are required to traverse along axial distance. Accordingly, the gap distance d may be quicklyreduced through relatively few rotations of adjusting knob (98).Proximal portion (96C) of the present example is substantially similarto distal portion (96A) and comprises a fine pitch or a high number ofgrooves over a short axial distance of grooved shank (94) such that alarge number of rotations are required to traverse the short axialdistance. Proximal portion (96C) of the present example is positionedwithin sleeve (92) when anvil (40) is substantially near to staplinghead assembly (20) such that indicator bar (110) moves within indicatorwindow (120) along scale (130) to indicate that the anvil gap is withina desired operating range, as will be described in more detail below.Accordingly, when the tab is within proximal portion (96C) of groove(96), each rotation of adjusting knob (98) may reduce the gap distance dby a small amount to provide for fine tuning.

Trocar actuation assembly (90) may be further constructed in accordancewith at least some of the teachings of U.S. Pat. No. 5,205,459; U.S.Pat. No. 5,271,544; U.S. Pat. No. 5,275,322; U.S. Pat. No. 5,285,945;U.S. Pat. No. 5,292,053; U.S. Pat. No. 5,333,773; U.S. Pat. No.5,350,104; U.S. Pat. No. 5,533,661, the disclosures of which areincorporated by reference herein; and/or in accordance with otherconfigurations as will be apparent to one of ordinary skill in the artin view of the teachings herein.

In the example shown in FIGS. 4A-4B, a U-shaped clip (100) is attachedto an intermediate portion of trocar actuator (39) located distally ofgrooved shank (94). In the present example, an extension of trocaractuator (39) engages a slot in the housing of handle assembly (70) toprevent trocar actuator (39) from rotating about its axis when adjustingknob (98) is rotated. In some other versions, U-shaped clip (100)engages with a portion of body (72) to substantially prevent trocaractuator (39) from rotating about its axis when adjusting knob (98) isrotated. U-shaped clip (100) of the present example further includes anelongated slot (102) on each of its opposite sides for receiving anattachment member, such as a screw, bolt, pin, clip, etc., toselectively adjust the longitudinal position of elongated slot (102) ofU-shaped clip (100) relative to trocar actuator (39) for purposes ofcalibrating indicator bar (110) relative to scale (130).

As shown in FIG. 5, actuator handle assembly (70) further includes anindicator bracket (140) configured to engage and pivot an indicator(104). Indicator bracket (140) of the present example is slidablerelative to body (72) along a pair of slots formed on body (72).Indicator bracket (140) comprises a rectangular plate (144), anindicator arm (146), and an angled flange (142). Angled flange (142) isformed at the proximal end of rectangular plate (144) and includes anaperture (not shown) to slidable mount onto trocar actuator (39) and/orgrooved shank (94). A coil spring (150) is interposed between flange(142) and a boss (152) to bias flange (142) against U-shaped clip (100).Accordingly, when U-shaped clip (100) actuates distally with trocaractuator (39) and/or grooved shank (94), coil spring (150) urgesindicator bracket (140) to travel distally with U-shaped clip (100). Inaddition, U-shaped clip (100) urges indicator bracket (140) proximallyrelative to boss (152) when trocar actuator (39) and/or grooved shank(94) translate proximally, thereby compressing coil spring (150). Ofcourse, it should be understood that in some versions indicator bracket(140) may be fixedly attached to trocar actuator (39) and/or groovedshank (94).

In the present example, a portion of lockout feature (82) abuts asurface (141) of indicator bracket (140) when indicator bracket (140) isin a longitudinal position that does not correspond to when the anvilgap is within a desired operating range (e.g., a green colored region or“green zone”). When the anvil gap is within a desired operating range(e.g., a green colored region or “green zone”), indicator bracket (140)narrows to provide a pair of gaps (145) on either side of an indicatorarm (146) that permits lockout feature (82) to pivot, thereby releasingtrigger (74). Accordingly, lockout feature (82) and indicator bracket(140) can substantially prevent a user from releasing and operatingtrigger (74) until anvil (40) is in a predetermined operating range. Ofcourse it should be understood that lockout feature (82) may be omittedentirely in some versions.

This operating range may be visually communicated to the user via anindicator bar (110) of an indicator (104) shown against a scale (130),described briefly above. At the distal end of indicator bracket (140) isa distally projecting indicator arm (146) which terminates at alaterally projecting finger (148) for controlling the movement ofindicator (104). Indicator arm (146) and finger (148), best shown inFIG. 5, are configured to engage a tab (106) of indicator (104) suchthat indicator (104) is pivoted when indicator bracket (140) is actuatedlongitudinally. In the present example, indicator (104) is pivotablycoupled to body (72) at a first end of indicator (104), though this ismerely optional and other pivot points for indicator (104) will beapparent to one of ordinary skill in the art in view of the teachingsherein. An indicator bar (110) is positioned on the second end ofindicator (104) such that indicator bar (110) moves in response to theactuation of indicator bracket (140). Accordingly, as discussed above,indicator bar (110) is displayed through an indicator window (120)against a scale (130) (shown in FIG. 6) to show the relative gapdistance d between anvil (40) and stapling head assembly (20).

Of course indicator bracket (140), indicator (104), and/or actuatorhandle assembly (70) may be further constructed in accordance with atleast some of the teachings of U.S. Pat. No. 5,205,459; U.S. Pat. No.5,271,544; U.S. Pat. No. 5,275,322; U.S. Pat. No. 5,285,945; U.S. Pat.No. 5,292,053; U.S. Pat. No. 5,333,773; U.S. Pat. No. 5,350,104; U.S.Pat. No. 5,533,661, the disclosures of which are incorporated byreference herein; and/or in accordance with other configurations as willbe apparent to one of ordinary skill in the art in view of the teachingsherein.

II. Exemplary Motorized Circular Stapling Surgical Instrument WithSelectable Control

In some instances, it may be desirable to provide motorized control ofinstrument (10). It may further be desirable to enable a user to selectbetween either motorized control or manual control of a motorizedversion of circular surgical stapling instrument (10). For example,instrument (10) may include an operational mode selection assembly thatallows the user to disengage an automated, motorized rotary actuationsystem and provide manual actuation of that system. It may also bedesirable to provide a switch assembly for changing the mode of a singlerotary drive between a tissue clamping mode and a tissuecutting/stapling mode. In other words, such a switch assembly may enablea single rotary drive to either actuate anvil (40) clamping features oractuate knife (36) and staple driving features of instrument (10). Theexamples below include merely illustrative versions of instrument (10)where a single motor can be used to control both clamping andcutting/stapling of tissue via a single rotary drive; where the operatorcan select between motorized operation and manual operation; and astapling head cartridge assembly that is responsive to the single rotarydrive in motorized and manual operation.

A. Exemplary Operational Mode Selection Assembly

FIG. 7 shows another exemplary circular stapling instrument (210), whichis a selectively motorized variation of instrument (10). Instrument(210) of this example comprises a stapling head assembly (220), an anvil(240), a shaft assembly (260), and a handle assembly (270). Staplinghead assembly (220) is similar to stapling head assembly (20) in thatstapling head assembly (220) selectively couples with anvil (240).Stapling head assembly (220) is operable to clamp tissue between staplepockets (32) and staple forming pockets (52) of anvil (240). Staplinghead assembly (220) comprises a cylindrical knife (36) that is operableto sever tissue captured between stapling head assembly (220) and anvil(240). Stapling head assembly (220) drives staples (66) through thetissue captured between stapling head assembly (220) and anvil (240).Stapling instrument (210) may be used to create a secure anastomosis(e.g., an end-to-end anastomosis) within a gastro-intestinal tract of apatient or elsewhere.

Stapling head assembly (220) differs from stapling head assembly (20) inthat stapling head assembly (220) is operable to clamp tissue, severtissue, and staple tissue all in response to a single rotary inputcommunicated via shaft assembly (260). Accordingly, actuation inputstranslated linearly through shaft assembly (260) are not required forstapling head assembly (220), though stapling head assembly (220) maycomprise a translating clutch feature. By way of example only, at leastpart of stapling head assembly (220) may be configured in accordancewith at least some of the teachings of U.S. Patent App. No. [ATTORNEYDOCKET NO. END7161USNP.0597922], entitled “Motor Driven Rotary InputCircular Stapler with Modular End Effector,” filed on even dateherewith, the disclosure of which is incorporated by reference herein.Other suitable configurations for stapling head assembly (220) will beapparent to those of ordinary skill in the art in view of the teachingsherein.

Shaft assembly (260) is similar to shaft assembly (60) in that shaftassembly (260) couples handle assembly (270) with stapling head assembly(220). Shaft assembly (260) differs from shaft assembly (60) in thatshaft assembly (260) comprises a single actuation feature, rotary driveractuator (264) shown in FIG. 8. Driver actuator (264) is operable todrive stapling head assembly (220) to clamp tissue, sever tissue, andstaple tissue. Accordingly, linear actuation through shaft assembly(260) is not required, though rotary driver actuator (264) may translatelongitudinally to shift between a tissue clamping mode and a tissuecutting/stapling mode. For instance, driver actuator (264) may translatefrom a first longitudinal position, in which rotation of driver actuator(264) provides clamping of tissue at stapling head assembly (220), to asecond longitudinal position, in which rotation of driver actuator (264)provides cutting and stapling of tissue at stapling head assembly (220).Some versions of shaft assembly (260) may include one or more flexiblesections. An example of a shaft assembly that is configured withflexible sections and that may be incorporated into shaft assembly (260)is disclosed in U.S. Patent App. No. [ATTORNEY DOCKET NO.END7163USNP.0597933], entitled “Motor Driven Rotary Input CircularStapler with Lockable Flexible Shaft,” filed on even date herewith, thedisclosure of which is incorporated by reference herein. Alternatively,shaft assembly (260) may be rigid along the length of shaft assembly(260) or have one or more flexible sections configured in some otherfashion.

Handle assembly (270) is shown in FIGS. 8-10. Handle assembly (270)comprises a handle housing (272), a motor housing (274), a motor (280),a battery (281), a rotation knob (298), an operational mode selectionassembly (which is shown in FIGS. 11A-11B), and a firing ring (252).Motor housing (274) is positioned within handle housing (272). Handlehousing (272) comprises ribs (255, 256, 257) extending inwardly intohandle housing (272) to support motor housing (274), as shown in FIG. 9.Battery (281) is positioned proximal to motor (280) within motor housing(274). Battery (281) may be removed from motor housing (274) to bereplaced, discarded, or recharged. As best seen in FIG. 10, battery(281) comprises electrical contacts (231, 232) extending distally frombattery (281). Motor (280) comprises electrical contacts (233, 234)extending proximally from motor (280). Battery electrical contact (232)and motor electrical contact (234) are coupled via conductive metal band(242). Screw (243) couples band (242) to motor housing (274) to fix theposition of band (242) relative to motor housing (274). Accordingly,band (242) is configured to constantly couple battery electrical contact(232) and motor electrical contact (234).

As shown in FIG. 10, battery electrical contact (231) is coupled to aconductive metal band (245). Metal band (245) is secured to motorhousing (274) via a conductive screw (247). Motor electrical contact(233) is coupled to a conductive metal band (244). Metal band (244) issecured to motor housing (274) via a conductive screw (246). Motorhousing (274) is formed of an electrically insulative material (e.g.,plastic) and comprises annular contacts (284, 286) wrapped around motorhousing (274). Screws (246, 247) are each coupled with a respectiveannular contact (284, 286) to electrically couple battery electricalcontact (231) and motor electrical contact (233) to annular contacts(284, 286), respectively.

Another conductive metal band (282) is secured to handle housing (272).Each end of metal band (282) forms a respective spring contact (283,285). Motor housing (274) translates proximally and/or distally relativeto handle housing (272) to selectively couple and/or decouple springcontacts (283, 285) with annular contacts (284, 286). In particular,when motor housing (274) is in a distal position (FIG. 15A), springcontact (283) engages annular contact (284) and spring contact (285)engages annular contact (286) to couple battery (281) with motor (280)and supply power to motor (280). It should be understood that, sincespring contacts (283, 285) are part of the same conductive metal band(282), and since contacts (232, 234) are already coupled via band (242),the engagement between spring contacts (283, 285) and annular contacts(284, 286) completes a circuit between battery (281) and motor (280).This positioning is used to provide motorized actuation of stapling headassembly (220) as will be described in greater detail below. When motorhousing (274) is in a proximal position (FIG. 17A), spring contacts(283, 285) are decoupled from annular contacts (284, 286), such thatbattery (281) is decoupled from motor (280) and motor (280) does notreceive power. This positioning is used to provide manual actuation ofstapling head assembly (220) as will be described in greater detailbelow. The annular shape of annular contacts (284, 286) enables propercontact between spring contacts (283, 285) and annular contacts (284,286) regardless of the angular position of motor housing (274) withinhandle housing (272). In some versions, band (282) may include a breakthat is coupled with an external switch, such that a user may actuatethe external switch in order to complete the coupling between battery(281) and motor (280) after motor housing (274) is in the distalposition.

A proximal end of motor housing (274) is fixedly secured to rotationknob (298), as shown in FIG. 8. Rotation knob (298) protrudes proximallyfrom handle housing (272) and comprises splines (296) extending distallyfrom rotation knob (298). Handle housing (272) comprises correspondingteeth (251) to selectively engage splines (296). Rotation knob (298) ispulled and/or pushed to translate motor housing (274) within handlehousing (272). When rotation knob (298) is in a proximal position (FIG.17A), splines (296) are disengaged from handle housing (272) such thatrotation knob (298) and motor housing (274) are free to rotate relativeto handle housing (272). This positioning is used to provide manualactuation of stapling head assembly (220) as will be described ingreater detail below. When rotation knob (298) is in a distal position(FIG. 15A), splines (296) engage corresponding teeth (251) in handlehousing (272) to lock rotation knob (298) and motor housing (274) fromrotating relative to handle housing (272). Splines (296) and teeth (251)thus provide a mechanical ground for motor housing (274) relative tohandle housing (272). This positioning is used to provide motorizedactuation of stapling head assembly (220) as will be described ingreater detail below. Rotation knob (298) is biased to the distalposition by a resilient member (279) in handle housing (272). Inparticular, resilient member (279) extends distally from rib (255) ofhandle housing (272) to a first gear (278), which is unitarily securedto the distal end of motor housing (274). When rotation knob (298) is inthe proximal position, resilient member (279) compresses between firstgear (278) and rib (255) to resiliently bias handle housing (272) to thedistal position.

An operational mode selection assembly is positioned distal to motorhousing (274) within handle housing (272). As shown in FIGS. 11-13, theoperational mode selection assembly comprises a first gear (278) and asecond gear (276), with first gear (278) being coaxially and slidablydisposed about second gear (276). First gear (278) comprises squareteeth (277) aligned around an inner opening of first gear (278), asshown in FIG. 12. Teeth (277) define a circumferentially spaced array ofrecesses. Second gear (276) comprises a shaft (273), splines (275), andannular flanges (258), as shown in FIG. 13. Shaft (273) has a distallypresented opening (259). Distally presented opening (259) is hexagonalto receive proximal end (263) of driver actuator (264), which is alsohexagonal (FIG. 8). Shaft (273) also has a proximally presented opening(not shown) that is semi-circular to complement and receive drive shaft(287) extending distally from motor (280). Other suitable shapes andconfigurations of shafts (263, 287) may used to couple second gear (276)with shafts (263, 287).

Splines (275) of second gear (276) are positioned on a proximal end ofshaft (273) and extend distally. Splines (275) correspond to teeth (277)of first gear (278), such that splines (275) are configured to fitwithin the recesses defined between teeth (277). A pair of annularflanges (258) are positioned at a distal end of shaft (273) and extendoutwardly to engage an inwardly extending annular rib (253) of handlehousing (272), thereby fixing the longitudinal position of second gear(276) within handle housing (272). While annular rib (253) fixes thelongitudinal position of second gear (276) within handle housing (272),annular rib (253) nevertheless allows second gear (276) to rotaterelative to handle housing (272). Other suitable engagement features tolongitudinally fix second gear (276) will be apparent to one withordinary skill in the art based on the teachings herein.

First gear (278) is positioned around second gear (276), as shown inFIGS. 11A-11B. First gear (278) is fixedly coupled to a distal end ofmotor housing (274) such that first gear (278) translates and rotatesunitarily with motor housing (274). When motor housing (274) is in aproximal position, as shown in FIGS. 11B and 17A, motor (280) and firstgear (278) are also in a proximal position. In this position, driveshaft (287) of motor (280) is disengaged from second gear (276) andteeth (277) of first gear (278) engage splines (275) of second gear(276). Thus, when rotation knob (298) rotates, motor housing (274) andfirst gear (278) also rotate. This positioning thereby provides manualactuation of stapling head assembly (220), as will be described ingreater detail below. With teeth (277) of first gear (278) engaged withsplines (275), rotation knob (298) thereby rotates second gear (276)relative to motor housing (274). When motor housing (274) is in a distalposition, as shown in FIGS. 11A and 15B, motor (280) and first gear(278) are also in a distal position. Motor (280) is engaged with secondgear (276) via shafts (287, 273). First gear (278) slides over shaft(273) of second gear (276) to disengage splines (275). Thus, therotation of drive shaft (287) of motor (280) thereby rotates second gear(276). This positioning thereby provides motorized actuation of staplinghead assembly (220), as will be described in greater detail below. Inother words, when knob (298) and motor housing (274) are in a distalposition as shown in FIGS. 11A and 15B, motor (280) rotates second gear(276). When knob (298) and motor housing (274) are in a proximalposition as shown in FIGS. 11B and 17A, knob (298) rotates second gear(276).

Referring back to FIGS. 8-9, a distal end of second gear (276) iscoupled to driver actuator (264), such that rotation of second gear(276) rotates driver actuator (264). Driver actuator (264) is similar todriver actuator (64). Accordingly, when second gear (276) is rotated,driver actuator (264) is rotated to adjust the gap distance d betweenanvil (240) and stapling head assembly (220). Handle housing (272)further comprises firing ring (252) and coupling member (268). Couplingmember (268) is secured around recess (261) of driver actuator (264), asshown in FIG. 8. Accordingly, coupling member (268) translates withdriver actuator (264), but driver actuator (264) is free to rotatewithin coupling member (268). Coupling member (268) comprisesprotrusions extending outwardly that connect coupling member (268) tofiring ring (252). The protrusions of coupling member (268) extendthrough slots (265, 266, 267) of housing assembly (272), as shown inFIG. 14. Slot (265) extends circumferentially about part of handleassembly (272). Slot (266) extends proximally from slot (265). Slot(267) extends transversely from slot (266) and is substantially parallelwith slot (265). Firing ring (252) is wrapped around handle housing(272) and is rotatable and translatable relative to handle housing (272)to manually drive the protrusions of coupling member (268) through slots(265, 266, 267).

When firing ring (252) is in a distal position, protrusions of couplingmember (268) are positioned within slot (265) of handle housing (272).When coupling member (268) is positioned within slot (265), couplingmember (268) couples driver actuator (264) with features in staplinghead assembly (220) operable to adjust the gap distance d between anvil(240) and stapling head assembly (220). For instance, if coupling member(268) is rotated clockwise within slot (265), the gap distance d isdecreased to close anvil (240) relative to stapling head assembly (220).If coupling member (268) is rotated counterclockwise within slot (265),the gap distance d is increased to open anvil (240) relative to staplinghead assembly (220). A resilient member (269) is positioned proximal tocoupling member (268) to bias coupling member (268) distally (FIG. 8).Coupling member (268) of firing ring (252) may then be translatedproximally through slot (266) to slot (267). When firing ring (252) isin the proximal position, protrusions of coupling member (268) arepositioned within slot (267). When coupling member (268) is positionedwithin slot (267), coupling member (268) couples driver actuator (264)with features in stapling head assembly (220) that drive knife (36) andstaples (66) in response to rotation of driver actuator (264). Forinstance, if coupling member (268) is rotated clockwise within slot(267), stapling head assembly (220) drives knife (36) and staples (66).The configuration of slot (367) prevents coupling member (268) frombeing rotated counterclockwise. Other suitable coupling member (268)rotation configurations will be apparent to one with ordinary skill inview of the teachings herein.

As shown in FIG. 9, a switch (248) is positioned in handle housing (272)to align with coupling member (268). When the motorized operational modeis selected, switch (248) is configured to electrically couple motor(280) and battery (281) when switch (248) is depressed, and switch (248)is configured to electrically decouple motor (280) and battery (281)when switch (248) is not depressed. Coupling member (268) is configuredto engage and depress switch (248) when coupling member (268) isrotated. For instance, when coupling member (268) is in a neutralposition (e.g., when coupling members (268) are aligned with respectiveslots (266)), switch (248) is not depressed and motor (280) is decoupledfrom battery (281). When coupling member (268) is rotated away from theneutral position, coupling member (268) engages switch (248) to depressswitch (248) and couple motor (280) with battery (281) to operateinstrument (210). It should be understood that housing (272) may includethree switches (248). For instance, one switch (248) may be positionedfor activation when firing ring (252) is rotated clockwise while in theproximal position (e.g., with coupling member (268) in slot (267)); withanother switch (248) being positioned for activation when firing ring(252) is rotated clockwise while in the distal position (e.g., withcoupling member (268) in slot (265)); with yet another switch (248)being positioned for activation when firing ring (252) is rotatedcounterclockwise while in the distal position. A control logic may be incommunication with the switches (248) that are activated when firingring (252) is rotated while in the distal position. Such a control logicmay be operable to selectively reverse the direction of rotation bymotor (280), to thereby provide selective advancement or retraction oftrocar (238) and anvil (240) to adjust the gap distance d, depending onthe direction in which firing ring (252) is rotated.

It should be understood that firing ring (252) and coupling member (268)act as a clutch control to shift driver actuator (264) from an anvilclamping mode (when coupling member (268) is in the distal position) toa cutting/stapling mode (when coupling member (268) is in the proximalposition). An example of a stapling head assembly (220) responsive tosuch changes in driver actuator (264) positioning is disclosed in U.S.Patent App. No. [ATTORNEY DOCKET NO. END7161USNP.0597922], entitled“Motor Driven Rotary Input Circular Stapler with Modular End Effector,”filed on even date herewith, the disclosure of which is incorporated byreference herein. Other suitable forms that stapling head assembly (220)may take will be apparent to those of ordinary skill in the art in viewof the teachings herein. Outer tubular member (262) is coupled toactuator handle assembly (270). Outer tubular member (262) is similar toouter tubular member (62) to provide a mechanical ground betweenstapling head assembly (220) and handle assembly (270).

1. Motorized Operation

FIGS. 15A-15C show instrument (210) during motorized operation. FIG. 15Ashows anvil (240) being coupled to trocar (238). Anvil (240) coupleswith trocar (238) in a manner similar to that described above withrespect to anvil (40) and trocar (38). When motorized operation isselected, rotation knob (298) is in a distal position. In the distalposition, splines (296) of rotation knob (298) engage correspondingteeth (251) in handle housing (272) to lock rotation knob (298) fromrotating relative to handle housing (272). When rotation knob (298) isin the distal position, motor housing (274) is also in a distalposition. When motor housing (274) is in the distal position, springcontacts (283, 285) are aligned with annular contacts (284, 286) tocouple electrical contact (231) of battery (281) with electrical contact(233) of motor (280). Power is supplied from battery (281) to motor(280) when coupling member (268) is rotated to depress switch (248).Motor (280) is engaged with second gear (276) via shafts (287, 273) andfirst gear (278) is disengaged from splines (275), thereby permittingsecond gear (276) to rotate relative to first gear (278), motor housing(274), and handle housing (272). Protrusions of coupling member (268)are positioned distally within slot (265) of handle housing (272) tolock the longitudinal position of firing ring (252) and driver actuator(264).

As shown in FIG. 15B, firing ring (252) is rotated clockwise totranslate coupling member (268) within slot (267). As coupling member(268) is rotated, switch (248) is depressed to couple motor (280) andbattery (281) and supply power to motor (280). Motor (280) is thusactivated to rotate shaft (287). Shaft (287) thereby rotates second gear(276). Because second gear (276) is coupled to driver actuator (264),the rotation of second gear (276) also rotates driver actuator (264).This rotation of driver actuator (264) drives features in stapling headassembly (220) to adjust the gap distance d between anvil (240) andstapling head assembly (220). Once anvil (240) is in a desired positionrelative to stapling head assembly (220), firing ring (252) is rotatedcounterclockwise to a neutral position to release switch (248) such thatmotor (280) is decoupled from battery (281). Instrument (210) may thenbe fired, as shown in FIG. 15C. Firing ring (252) is translated toposition coupling member (268) out of slot (265) to the proximalposition in slot (267). When coupling member (268) is translatedproximally to slot (267), coupling member (268) also translates driveractuator (264) proximally to couple driver actuator (264) with featuresin stapling head assembly (220) operable to drive knife (36) distallyand to drive staples (66) into anvil (240) to staple the clamped tissue(2, 4) to create an anastomosis. Firing ring (252) is rotated clockwisewithin slot (267) to depress switch (248) to again couple battery (281)with motor (280) to supply power to motor (280). Motor (280) is againrotated with coupling member (268) and driver actuator (264) in theproximal position. This rotation is communicated to driver actuator(264) via drive shaft (287) and second gear (276), and is therebycommunicated to driver actuator (264) to cut and staple tissue (2, 4).Firing ring (252) may then be rotated counterclockwise within slot (267)to the neutral position to release switch (248) and decouple motor (280)from battery (281).

2. Selection of Operation Mode

As shown in FIG. 16, instrument (210) is switched from motorizedoperation to manual operation. A user may grasp rotation knob (298) totranslate rotation knob (298) from the distal position to the proximalposition. In the proximal position, splines (296) of rotation knob (298)disengage from corresponding teeth (251) in handle housing (272) toallow rotation knob (298) to rotate relative to handle housing (272).This also allows motor housing (274) and first gear (278) to rotaterelative to handle housing (272). When rotation knob (298) is in theproximal position, motor housing (274) is also in a proximal position.When motor housing (274) is in the proximal position, spring contacts(283, 285) are offset from annular contacts (284, 286) to decouplebattery (281) from motor (280) such that no power is supplied to motor(280). First gear (278) translates proximally to engage splines (275) ofsecond gear (276). Thereby, rotation of rotation knob (298) rotatesmotor housing (274), first gear (278), second gear (276), and driveractuator (264). A user may also push rotation knob (298) back distallyto reselect motorized operation. By using rotation knob (298) as anactuator to select between motorized and manual operation, the need forlockouts or switches to simultaneously remove power to motor (280) iseliminated. Rotation knob (298) thus provides a “bailout” system ofmotorized operation, while allowing instrument (210) to be fullyoperational in the manual operational mode. It should therefore beunderstood that even if an operator initially uses instrument (210) in amotorized mode, the operator may quickly and easily convert instrument(210) to a manually operated mode simply by pulling on rotation knob(298), without sacrificing essential functionality of instrument (210).

3. Manual Operation

FIGS. 17A-17C show instrument (210) during manual operation. FIG. 17Ashows anvil (240) being coupled to trocar (238). Rotation knob (298) isin the proximal position, as described above. As shown in FIG. 17B,rotation knob (298) is rotated to rotate motor housing (274) relative tohandle housing (272). Motor housing (274) thereby rotates first gear(278). First gear (278) is engaged with splines (275) to rotate secondgear (276). Because second gear (276) is coupled to driver actuator(264), the rotation of second gear (276) also rotates driver actuator(264). This rotation of driver actuator (264) rotates features instapling head assembly (220) to adjust the gap distance d between anvil(240) and stapling head assembly (220). Once anvil (240) is in a desiredposition relative to stapling head assembly (220), instrument (210) maybe fired, as shown in FIG. 17C. Firing ring (252) is translated from thedistal position and out of slot (265) to the proximal position with slot(267). When coupling member (268) is translated proximally to slot(267), coupling member (268) also translates driver actuator (264)proximally to couple driver actuator (264) with features in staplinghead assembly (220) operable to drive knife (36) distally and to drivestaples (66) into anvil (240) to staple the clamped tissue (2, 4) tocreate an anastomosis. Rotation knob (298) is again rotated withcoupling member (268) and driver actuator (264) in the proximalposition. This rotation is communicated to driver actuator (264) viafirst gear (278) and second gear (276), and is thereby communicated todriver actuator (264) to cut and staple tissue (2, 4).

4. Control Assembly

FIG. 18 shows an exemplary control assembly (228) for use withinstrument (210). Control assembly (228) comprises a sensor (222), acontrol module (224), and a feedback feature (226). Feedback feature(226) may be operable to provide visual, audio, and/or haptic feedback(LED lights, LED display, speaker, vibration generator, etc.). Sensor(222) is coupled to instrument (210) and is configured to detectmovement within the drive train of instrument (210). For example, sensor(222) may comprise an encoder positioned to detect rotation of driveractuator (264) or some other rotating component of drive train (e.g, acomponent that rotates but does not also translate). Sensor (222) iscoupled with control module (224) to provide the sensed signal tocontrol module (224). Control module (224) is configured to process thesensed signal and may determine the selected operational mode ofinstrument (210), the gap distance d between anvil (240) and staplinghead assembly (220), and/or the firing of knife (36) and staples (66).In the present example, control module (224) is coupled with instrument(210) and feedback feature (226). However, control module (224) may becoupled with either of instrument (210) or feedback feature (226).Control module (224) may also be coupled with switch (248) to actuatemotor (280) when switch (248) is depressed. Each of sensor (222),control module (224), and feedback feature (226) may be located withininstrument (210) or remotely from instrument (210).

Based on the sensed signal, control module (224) is operable to actuateinstrument (210) and/or feedback feature (226). For example, controlmodule (224) may actuate feedback feature (226) to indicate the selectedoperational mode of instrument (210). In some versions, feedback feature(226) may have a first LED corresponding to the motorized operationalmode and a second LED corresponding to the manual operational mode.Sensor (222) may detect the proximal and/or distal position of rotationknob (298) and/or motor housing (274) and provide the information tocontrol module (224). Control module (224) may then illuminate the firstLED if sensor (222) detects the proximal position to indicate themotorized operational mode is selected. Control module (224) mayilluminate the second LED if sensor (222) detects the distal position toindicate the manual operational mode is selected. Alternatively,feedback feature (226) may have only one LED which is either illuminatedor not to indicate the operational mode, or feedback feature (226) mayhave a speaker to provide a sound when the operational mode is changed.

In some versions, control module (224) may actuate feedback feature(226) to indicate the selected mode of stapling assembly (220). Feedbackfeature (226) may have a first LED corresponding to the tissue clampingmode and a second LED corresponding to the firing mode. Sensor (222) maydetect the proximal and/or distal position of firing ring (252),coupling member (268) and/or driver actuator (264) and provide theinformation to control module (224). Control module (224) may thenilluminate the first LED if sensor (222) detects the distal position toindicate the tissue clamping mode is selected. Control module (224) mayilluminate the second LED if sensor (222) detects the proximal positionto indicate the firing mode is selected. Alternatively, feedback feature(226) may have only one LED which is either illuminated or not toindicate stapling head assembly (220) mode, or feedback feature (226)may have a speaker to provide a sound when stapling head assembly (220)mode is changed.

In addition or in the alternative, control module (224) may actuatefeedback feature (226) to indicate the gap distance d between anvil(240) and stapling head assembly (220). Sensor (222) may detect thenumber of rotations of driver actuator (264). Control module (224) maythen determine the gap distance d based on the sensed signal and actuatefeedback feature (226). Feedback feature (226) may comprise a pluralityof LEDs that individually illuminate to indicate the gap distance d. Asgap distance d increases, LEDs may illuminate to correspond to the gapdistance d. As gap distance d decreases, LEDs may turn off to correspondto the gap distance d. As another merely illustrative example, feedbackfeature (226) may comprise an LED display screen that provides areal-time indication of the gap distance d. Feedback feature (226) mayalso have a speaker that emits a sound that changes in either pitch orvolume to indicate the corresponding gap distance d. Alternatively, oneLED may be used to indicate when a particular gap distance d has beenreached, or a sound may be provided when the particular gap distance dhas been reached.

In versions where feedback feature (226) includes the capability ofproviding haptic feedback to the operator, it should be understood thatvarious conventional components may be incorporated into handle assembly(270) to provide such haptic feedback. It should also be understood thathaptic feedback may be provided through motor (280). By way of exampleonly, feedback feature (226) may be configured to provide a sine wavesignal to motor (280) to essentially rotate drive shaft (287) slightlyclockwise and then immediately rotating it slightly counterclockwise theexact same amount. The net result would be zero rotational displacementof drive shaft (287). When this sequence is repeated (e.g., in a rapidsuccession), the movement of drive shaft (287) may cause handle assembly(270) to vibrate or otherwise shake enough for the operator to feel itthrough the hand that grasps handle assembly (270). With the zero netmovement of drive shaft (287) through this feedback algorithm, thehaptic feedback may result in no net actuation of anything in headassembly (220), regardless of whether driver actuator (264) is in thedistal position or the proximal position. Such haptic feedback may beprovided to indicate the end of a stapling stroke, to indicate a lockoutcondition, and/or to indicate some other condition. Various othersuitable ways in which audio, visual, and/or haptic feedback may beprovided will be apparent to those of ordinary skill in the art in viewof the teachings herein.

In some versions, control module (224) may actuate instrument (210).Sensor (222) may be configured to detect when knife (36) and staples(66) have been fired. Control module (224) may thus automaticallyreverse motor (280) once knife (36) and staples (66) have been fired.Control module (224) may also actuate feedback feature (226) to indicateto a user that instrument (210) has been fired. Other suitable ways inwhich sensors (222), control module (224), and feedback feature (226)may be used will be apparent to those of ordinary skill in the art inview of the teachings herein. It should also be understood that suchfeatures may be simply omitted if desired.

B. Exemplary Switch Assembly

As described above, surgical stapling instrument (10, 210) has twosub-systems, a closure sub-system (to clamp tissue between anvil (40,240) and stapling head assembly (20, 220)) and a firing sub-system (todrive knife (36) and staples (66) distally toward anvil (40, 240)), inorder to create an anastomosis. It may be desirable to power bothsub-systems with a single rotary motor to eliminate the cost andpackaging of an additional motor and transmission. FIGS. 19-20 show anexemplary drive assembly (371) configured to power two sub-systems witha single rotary motor (380). While instrument (210) provided closure andfiring with a single rotary drive shaft, drive assembly (371) of thisexample provides closure and firing through two separate rotary driveshafts driven by a single motor (380). Drive assembly (371) comprises amotor (380), a transmission shaft (392), a solenoid (390), a closure rod(364), and a firing rod (362). Motor (380) comprises a shaft (368)extending from motor (380) and a gear (370) coupled to shaft (368).Transmission shaft (392) comprises a gear (372) engaged with gear (370)of motor (380). A gear (377) is positioned on the opposing end oftransmission shaft (392).

A pivoting swing arm (391) is wrapped around transmission shaft (392)such that transmission shaft (392) may freely rotate relative to swingarm (391), as shown in FIG. 18. Swing arm (391) extends fromtransmission shaft (392) and comprises a gear (376). Gear (376) isfixedly secured to swing arm (391). A pin (394) extends from swing arm(391) and is coaxial with gear (376). Pin (394) is pivotally supportedby a bracket (393), such that swing arm (391) is pivotable about pin(394) relative to bracket (393) in response to rotation of gear (376).Solenoid (390) comprises a gear (374) coupled to a rack (371). Rack(371) is also coupled to a gear (375), which engages gear (376) of swingarm (391). Alternatively, gear (374) of solenoid (390) may directlycouple to gear (376) of swing arm (391). Closure rod (364) comprises agear (378). Firing rod (362) is positioned adjacent to and substantiallyparallel with closure rod (364). Firing rod (362) comprises a gear(379). Gear (377) of transmission shaft (392) selectively swings toengage either gear (378) of closure rod (364) or gear (379) of firingrod (362).

As shown in FIGS. 19-20, transmission shaft (392) is positioned toengage closure rod (364). Accordingly, when motor (380) is activated,shaft (368) rotates gear (370). Gear (370) thereby rotates gear (372)and transmission shaft (392) to rotate gear (377). Because gear (377) isengaged with gear (378), transmission shaft (392) thereby rotatesclosure rod (364). Closure rod (364) may be used to adjust the gapdistance d between anvil (40, 240) and stapling head assembly (20, 220).If a user desires to switch to the firing sub-system, solenoid (390) maybe actuated. When solenoid (390) is actuated, solenoid (390) rotatesgear (374) to translate rack (371). Rack (371) then rotates gear (375)and gear (376) of swing arm (391). Gear (376) thereby pivots swing arm(391). As swing arm (391) pivots, swing arm (391) translatestransmission shaft (392) such that transmission shaft (392) disengagesclosure rod (364) and engages firing rod (362). Accordingly, when motor(380) is activated, shaft (368) rotates gear (370). Gear (370) therebyrotates gear (372) and transmission shaft (392) to rotate gear (377).Because gear (377) is now engaged with gear (379), transmission shaft(392) thereby rotates firing rod (362). Firing rod (364) may be used todrive knife (36) and staples (66) distally toward anvil (40, 240).Solenoid (390) may then be actuated again such that switch assembly(371) switches to the closure sub-system via swing arm (391).

Solenoid (390) may be button activated or be otherwise manuallyactivated. Alternatively, switching assembly (371) may incorporate logicsuch that solenoid (390) is activated automatically. For instance, auser may actuate drive assembly (371) by inputting a user input (310)into a control module (312), as shown in FIG. 19. Control module (312)is coupled to motor (380) and solenoid (390) to selectively actuatemotor (380) and/or solenoid (390) based on user input (310). Controlmodule (312) may be integral with instrument (10, 210), or controlmodule (312) may be a separate assembly. Suitable control module (312)configurations will be apparent to one with ordinary skill in the art inview of the teachings herein.

III. Miscellaneous

It should be understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Theabove-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

At least some of the teachings herein may be readily combined with oneor more teachings of U.S. Pat. No. 7,794,475, entitled “Surgical StaplesHaving Compressible or Crushable Members for Securing Tissue Therein andStapling Instruments for Deploying the Same,” issued Sep. 14, 2010, thedisclosure of which is incorporated by reference herein. Varioussuitable ways in which such teachings may be combined will be apparentto those of ordinary skill in the art.

Similarly, at least some of the teachings herein may be readily combinedwith one or more teachings of U.S. patent application Ser. No.13/693,430, entitled “Trans-Oral Circular Anvil Introduction System withDilation Feature,” filed Dec. 4, 2012, the disclosure of which isincorporated by reference herein. Various suitable ways in which suchteachings may be combined will be apparent to those of ordinary skill inthe art.

Similarly, at least some of the teachings herein may be readily combinedwith one or more teachings of U.S. patent application Ser. No.13/688,951, entitled “Surgical Staple with Integral Pledget for TipDeflection,” filed Nov. 29, 2012, the disclosure of which isincorporated by reference herein. Various suitable ways in which suchteachings may be combined will be apparent to those of ordinary skill inthe art.

Similarly, at least some of the teachings herein may be readily combinedwith one or more teachings of U.S. patent application Ser. No.13/706,827, entitled “Surgical Stapler with Varying Staple Widths AlongDifferent Circumferences,” filed Dec. 6, 2012, the disclosure of whichis incorporated by reference herein. Various suitable ways in which suchteachings may be combined will be apparent to those of ordinary skill inthe art.

Similarly, at least some of the teachings herein may be readily combinedwith one or more teachings of U.S. patent application Ser. No.13/688,992, entitled “Pivoting Anvil for Surgical Circular Stapler,”filed Nov. 29, 2012, the disclosure of which is incorporated byreference herein. Various suitable ways in which such teachings may becombined will be apparent to those of ordinary skill in the art.

Similarly, at least some of the teachings herein may be readily combinedwith one or more teachings of U.S. patent application Ser. No.13/693,455, entitled “Circular Anvil Introduction System with AlignmentFeature,” filed Dec. 4, 2012, the disclosure of which is incorporated byreference herein. Various suitable ways in which such teachings may becombined will be apparent to those of ordinary skill in the art.

Similarly, at least some of the teachings herein may be readily combinedwith one or more teachings of U.S. Patent App. No. U.S. Patent App. No.[ATTORNEY DOCKET NO. END7160USNP.0597930], entitled “Circular Staplerwith Selectable Motorized and Manual Control, Including a Control Ring,”filed on even date herewith, the disclosure of which is incorporated byreference herein. Various suitable ways in which such teachings may becombined will be apparent to those of ordinary skill in the art.

Similarly, at least some of the teachings herein may be readily combinedwith one or more teachings of U.S. Patent App. No. U.S. Patent App. No.[ATTORNEY DOCKET NO. END7161USNP.0597922], entitled “Motor Driven RotaryInput Circular Stapler with Modular End Effector,” filed on even dateherewith, the disclosure of which is incorporated by reference herein.Various suitable ways in which such teachings may be combined will beapparent to those of ordinary skill in the art.

Similarly, at least some of the teachings herein may be readily combinedwith one or more teachings of U.S. Patent App. No. [ATTORNEY DOCKET NO.END7163USNP.0597933], entitled “Motor Driven Rotary Input CircularStapler with Lockable Flexible Shaft,” filed on even date herewith, thedisclosure of which is incorporated by reference herein. Varioussuitable ways in which such teachings may be combined will be apparentto those of ordinary skill in the art.

It should be appreciated that any patent, publication, or otherdisclosure material, in whole or in part, that is said to beincorporated by reference herein is incorporated herein only to theextent that the incorporated material does not conflict with existingdefinitions, statements, or other disclosure material set forth in thisdisclosure. As such, and to the extent necessary, the disclosure asexplicitly set forth herein supersedes any conflicting materialincorporated herein by reference. Any material, or portion thereof, thatis said to be incorporated by reference herein, but which conflicts withexisting definitions, statements, or other disclosure material set forthherein will only be incorporated to the extent that no conflict arisesbetween that incorporated material and the existing disclosure material.

Versions of the devices described above may have application inconventional medical treatments and procedures conducted by a medicalprofessional, as well as application in robotic-assisted medicaltreatments and procedures. By way of example only, various teachingsherein may be readily incorporated into a robotic surgical system suchas the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, Calif.Similarly, those of ordinary skill in the art will recognize thatvarious teachings herein may be readily combined with various teachingsof U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool withUltrasound Cauterizing and Cutting Instrument,” published Aug. 31, 2004,the disclosure of which is incorporated by reference herein.

Versions described above may be designed to be disposed of after asingle use, or they can be designed to be used multiple times. Versionsmay, in either or both cases, be reconditioned for reuse after at leastone use. Reconditioning may include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, someversions of the device may be disassembled, and any number of theparticular pieces or parts of the device may be selectively replaced orremoved in any combination. Upon cleaning and/or replacement ofparticular parts, some versions of the device may be reassembled forsubsequent use either at a reconditioning facility, or by a userimmediately prior to a procedure. Those skilled in the art willappreciate that reconditioning of a device may utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

By way of example only, versions described herein may be sterilizedbefore and/or after a procedure. In one sterilization technique, thedevice is placed in a closed and sealed container, such as a plastic orTYVEK bag. The container and device may then be placed in a field ofradiation that can penetrate the container, such as gamma radiation,x-rays, or high-energy electrons. The radiation may kill bacteria on thedevice and in the container. The sterilized device may then be stored inthe sterile container for later use. A device may also be sterilizedusing any other technique known in the art, including but not limited tobeta or gamma radiation, ethylene oxide, or steam.

Having shown and described various embodiments of the present invention,further adaptations of the methods and systems described herein may beaccomplished by appropriate modifications by one of ordinary skill inthe art without departing from the scope of the present invention.Several of such potential modifications have been mentioned, and otherswill be apparent to those skilled in the art. For instance, theexamples, embodiments, geometrics, materials, dimensions, ratios, steps,and the like discussed above are illustrative and are not required.Accordingly, the scope of the present invention should be considered interms of the following claims and is understood not to be limited to thedetails of structure and operation shown and described in thespecification and drawings.

I/We claim:
 1. An apparatus for stapling tissue, the apparatuscomprising: (a) a stapling head assembly; (b) a shaft assembly coupledto the stapling head assembly; and (c) a handle assembly coupled to theshaft assembly, wherein the handle assembly comprises: (i) a motorpositioned within a motor housing, (ii) a motor housing positionercoupled to a proximal end of the motor housing, wherein the motorhousing positioner is configured to translate between a proximalposition and a distal position, and (iii) a selection assembly, whereinthe selection assembly is operable to select between a motorizedoperation of the stapling head assembly or a manual operation of thestapling head assembly based on the position of the motor housingpositioner.
 2. The apparatus of claim 1, wherein the motor housingpositioner comprises a rotation knob.
 3. The apparatus of claim 2,wherein the rotation knob comprises splines extending distally, whereinthe handle assembly comprises a housing, wherein the housing comprisesteeth corresponding with the splines, wherein the splines are configuredto engage the teeth during motorized operation such that the rotationknob is prevented from rotating.
 4. The apparatus of claim 1, whereinthe selection assembly is configured to select the motorized operationwhen the motor housing positioner is in the distal position, wherein theselection assembly is configured to select the manual operation when themotor housing positioned is in the proximal position.
 5. The apparatusof claim 1, wherein the handle assembly further comprises a battery. 6.The apparatus of claim 5, wherein the battery is operable to supplypower to the motor during motorized operation.
 7. The apparatus of claim6 further comprising spring contacts, wherein the spring contacts areoperable to supply power from the battery to the motor based on theposition of the motor housing positioner.
 8. The apparatus of claim 1,wherein the selection assembly comprises a first gear and a second gear,wherein the first gear is coupled to the motor housing, wherein thesecond gear comprises splines.
 9. The apparatus of claim 8, wherein thefirst gear is configured to engage the splines of the second gear duringmanual operation.
 10. The apparatus of claim 8, wherein the first gearis configured to be decoupled from the splines of the second gear duringmotorized operation.
 11. The apparatus of claim 1, wherein the shaftassembly comprises a driver actuator, wherein the driver actuator isoperable to actuate the stapling head assembly.
 12. The apparatus ofclaim 11, wherein the motor is operable to actuate the driver actuatorduring motorized operation.
 13. The apparatus of claim 11, wherein themotor housing positioner is operable to actuate the driver actuatorduring manual operation.
 14. The apparatus of claim 11, wherein thehandle assembly comprises a firing ring, wherein the firing is operableto translate the driver actuator.
 15. The apparatus of claim 14, whereinthe handle assembly comprises slots, wherein the handle assemblycomprises a coupling member extending through the slots to couple withthe firing ring, wherein the coupling member is configured to translatethrough the slots to lock the longitudinal position of the firing ring.16. An apparatus for stapling tissue, the apparatus comprising: (a) aclosure assembly operable to clamp tissue between an anvil and astapling head assembly; (b) a firing assembly operable to drive a knifeand at least one staple through tissue from the stapling head assemblytoward the anvil; and (c) a drive assembly, wherein the drive assemblycomprises: (i) a motor, (ii) a pivoting member coupled to the motor,(iii) a firing rod, wherein the firing rod is operable to actuate thefiring system, and (iv) a closure rod, wherein the closure rod isoperable to actuate the closure system; wherein the pivoting member isconfigured selectively switch between engaging either the firing rod orthe closure rod such that the motor is operable to actuate the firingrod when the pivoting member is engaged with the firing rod and themotor is operable to actuate the closure rod when the pivoting member isengaged with the closure rod.
 17. The apparatus of claim 16, wherein thedrive assembly comprises a solenoid, wherein the solenoid is operable topivot the pivoting member between engaging the firing rod and theclosure rod.
 18. An apparatus for stapling tissue, the apparatuscomprising: (a) a stapling head assembly; (b) a shaft assembly coupledto the stapling head assembly; and (c) a handle assembly coupled to theshaft assembly, wherein the handle assembly comprises: (i) a motor,wherein the motor is operable to actuate the stapling head assembly in amotorized operational mode, (ii) a rotation knob, wherein the rotationknob is configured to translate between a first position and a secondposition, wherein the rotation knob is operable to actuate the staplinghead assembly in a manual operational mode, and (iii) a selectionassembly, wherein the selection assembly is operable to provide themotorized operational mode when the rotation knob is in the firstposition, wherein the selection assembly is operable to provide themanual operational mode when the rotation knob is in the secondposition.
 19. The apparatus of claim 18, wherein the first position ofthe rotation knob is a distal position, wherein the second position ofthe rotation knob is a proximal position.
 20. The apparatus of claim 18,wherein the stapling head assembly is coupleable to an anvil, whereinthe stapling head assembly is operable to clamp tissue between the anviland the stapling head assembly, wherein the stapling head assemblycomprises a knife and a plurality of staples aligned in a circularconfiguration, wherein the stapling head assembly is operable to drivethe knife and the staples through tissue from the stapling head assemblytoward the anvil.